So how did Covid shape the post-pandemic community pharmacy landscape? Kam Kalsi, the supplier services manager, marketing intelligence at IQVIA, explains…

The UK community pharmacy sector has been revolutionised by the needs exacerbated by the pandemic. The year 2020 was a challenging one for community pharmacy, the NHS and the UK nation as a whole.

I will explore how the pandemic has shaped patient habits and the prescription and community pharmacy markets.

At the start of the first UK lockdown in March 2020, a rapid decrease in the number of face-to-face GP appointments was observed across England, with a 50-50 split between in person and telephone consultations from an existing 80-20 split in favour of face-to-face appointments.

The number of face-to-face GP consultations have gradually increased since the end of lockdown restrictions, however, numbers do not yet appear to be returning to pre-pandemic levels (Figure 1).

Figure 1. GP consultation trend January 2019 - October 2022

Source: NHS digital appointment in General Practice Data (October 2022) NHS Digital Copyright 2022.

Licensed under Open Government Licence

This change in GP accessibility was aligned to a surge in Electronic Prescription Service (EPS) nominations, which has not declined in the post pandemic period. In October 2022, 95.7 per cent of all prescriptions were electronic, compared to 74 per cent in October 2019 (Reference: NHS England EPS claimed items and nominations; November 2022).

Many patients opted to use Distance Selling Pharmacies (DSPs) in the early days of the pandemic as the public were told to “stay at home.” Since the start of the pandemic, the dependency on online pharmacy has continued to grow in line with convenience and the trend to work from home.

IQVIA estimates that in the pre-pandemic period (MAT to October 2019), 2.8 per cent of dispensed items were dispensed online, whilst in the MAT to October 2022 this channel accounted for 5.7 per cent of all items and in the month of October 2022 5.9 per cent of items were supplied by a DSP.

Pharmacy2U have continued to show strong growth and LloydsDirect (formerly ECHO) also displayed an uplift which has been maintained over time (Figure 2). Some of this growth may be a redistribution of brick-and-mortar prescriptions to the DSP hub to free up capacity at a branch level, however, it is clear to see that online dispensing continues to disrupt and influence the market.

Figure 2. EPS dispensing and nominations trend March 2020 - November 2022

Source: NHS England EPS Claimed Items & Nominations November 2022 NHS Digital Copyright 2022.

Licensed under Open Government Licence

Pharmacy purchasing data since March 2020 (Figure 3) shows that independent pharmacies have seen an increase in purchasing share to the detriment of larger corporations.

An accelerated growth of independents is notable in the post pandemic period to date, as many patients continue to work from home and use the ‘stay local’ approach. It appears that post pandemic patient and GP behaviour has also contributed to the decline of managed and national chains. There have also been losses in managed and national chain channels as larger groups continue to divest branches.

It would be a fair assumption to conclude that these branches have been purchased by independent groups and regional chains.

Figure 3. Changes in pharmacy purchasing

Source: IQVIA Wholesale Sales Data (Sell-In) November 2022

The Covid pandemic has shaped the post pandemic community pharmacy landscape. Lack of GP accessibility and online advice has increased the demand for community pharmacy to undertake a patient facing NHS service.

Independent pharmacies have gained momentum and regional chains continue to steadily grow in number, with both these channels building long term loyalty and relationships with patients.

The PSNC has highlighted that community pharmacy needs sustainable funding due to operational and financial pressures as its costs and workload continue to rise. (Reference: PSNC Briefing, January 2022, ‘Community pharmacy funding and capacity’).

Pharmacy bodies including PSNC are currently discussing this concern with the UK government.